Caries (clinical application)

1. KARAGANDA STATE MEDICAL UNIVERSITY.

Report: Caries (clinical application).
Made by: Belostockiy A.I.
Karagandy,2016.

2.

More than half of general dental practice deals with repair of
damage done by dental caries. Caries presents a major problem
to every dentist constantly. In some cases open carious cavities
exist for years without reaching the pulp, while in other cases
thorough examination reveals a dentition in a perfect condition.

3.

It would be well to make it a rule to remove first the soft dentin with a hand
instrument after having widened the entrance in the enamel with a chisel. A bur
not be used without having made a diagnosis of whether or not the carious
process is walled off by hypercalcified dentin.

4.

The decision as to further procedure is quite different in two cases. When a hard resistance
is found on all sides, the border of the opaque dentin has been reached. Now it is time to
use the bur and to prepare the cavity according to the rules of retention and extension.
Opaque dentin is mostly yellowish-brown, and if it is hard, there is no indication for its
removal.

5.

These cases lend themselves to comfortable cavity preparation without likelihood of an
accident. If, however, there were no shift of calcium salts producing a barrier of
hypercalcified opaque dentin, the caries would go straight to the pulp in every case. The
presence of the tubules offers plenty of opportunity for the progress of microorganisms.

6.

• A closed barrier of opaque dentin is not formed in
all cases to make cavity preparation comfortable. If
layer by layer of sift dentin is peeled out with a
hand instrument, the pulp is bound to be opened.

7.

• In such a case it is best to stop at some distance from
the pulp, not removing all softened dentin, which is
then impregnated with silver nitrate, and a temporary
filling of oxyphosphate cement is placed with a base of
zink oxide and eugenol. This temporary filling should
remain at least three months. After that time, as a rule,
the cavity preparation can be made without opening
the pulp.

8. THE PRINCIPAL REASONS FOR RESTORING CARIOUS PRIMARY TEETH ARE:

• To eradicate disease and restore health.
It should no more be ignored than disease of permanent teeth.
• To give the child the simplest form of treatment.
When caries is treated early, a minimal restoration suffices.
• To prevent the child suffering pain.
Although untreated caries does no always cause pain,
it is more likely to do so as it nears the pulp and, especially,
if a pulpal or periapical abscess is formed.
• To avoid the infection that follows carious exposure of the pulp.
Exposure of the pulp permits oral bacteria to gain access to the pulp
chamber,
root canals and periapical tissues.
• To preserve space that is required for eruption of permanent teeth.
• To ensure comfortable and efficient mastication.

9. Conditional Sentences

A conditional sentence is a complex sentence with a subordinate clause of condition
that usually begins with the conjunction IF. The clause of condition (the if-clause)
indicates the conditions under which the action in the main clause may be realized.
For the
purposes of
studying,
conditional
sentences
are usually
divided into
three main
types:

10. First conditional

Often called the "real" conditional because it is used for real or possible
situations. These situations take place if a certain condition is met. It is
possible and also very likely that the condition will be fulfilled.
Form:
• If + Simple Present, + Simple Future
Use
Conditional Sentences Type 1 refer to the future. An action in the future
will only happen if a certain condition is fulfilled by that time. We don't
know for sure whether the condition actually will be fulfilled or not,
but the conditions seems rather realistic – so we think it is likely to
happen.
Example:
• If I have enough time, I'll watch the football match.
• I may have time to watch the match but I'm not sure about it.

11. Second conditional

Often called the "unreal" conditional because it is used for unreal impossible or improbable
situations. This conditional provides an imaginary result for a given situation. It is very
unlikely that the condition will be fulfilled.
Form:
• if + Simple Past, + would + base verb
Were / Was
In conditional type 2, we usually use in the if clause "were" instead of "was" even if the
pronoun is I, he, she or it. "were" here is a subjunctive form.
NOTE "was" is also a possible form.
Example:
• If I were a millionaire, I would buy a castle.
Use
• Conditional Sentences Type 2 refer to an action in the present that could happen if the
present situation were different. I don't really expect the situation to change because it
is very unlikely.
Example:
• If I had a lot of money, I would travel around the world.